Current through Register Vol. 46, No. 12, March 20, 2024
(a) Every general
hospital (hereinafter, "hospital") shall adopt a detailed emergency Surge and
Flex Response Plan (hereinafter, "plan") that, at a minimum, includes the
following elements:
(1) Bed surge plan. The plan
shall explain how the hospital will increase the number of current staffed acute
care operational beds to a number set by the Commissioner, which shall be up to a
50% increase of such beds within seven days from the date of the declaration of
the state disaster emergency. For the purposes of this Part, an "acute care
operational bed" means a bed that is staffed and equipped with appropriate
infrastructure such that it can be used to deliver health care services to a
patient. The Commissioner may further define the type of acute care operational
beds for a given state disaster emergency, which may include isolation beds,
intensive care (ICU) beds, pediatric and/or acute care beds. The plan shall
contain scenarios for increases of current staffed acute care operational beds in
phased increments, detailing the associated considerations for PPE, staffing, and
other supplies and equipment, including whether the hospital can meet those
requirements using internal resources and capabilities, as well as intra-system
load balancing and postponement of some or all non-essential elective procedures.
These plans shall inform the Commissioner's directives, which shall be
incremental and geographically tailored at the Statewide, regional, or community
level, as dictated by infection rate data.
(2) PPE surge plan. The plan shall explain how
the hospital will increase its supply of personal protective equipment (PPE)
appropriate for use in a pandemic to achieve continuous maintenance of its
required 60-day supply of PPE, pursuant to section
405.11(g) of this
Title. The plan shall list the contracted entities or other supply chain
agreements executed by the hospital. Such plan shall further include, as
appropriate, how the hospital will repurpose existing equipment, replenish the
inventory from other areas of the health system, and establish cooperative
agreements to obtain PPE to accommodate supply chain interruptions. A PPE surge
plan may provide for hospital utilization of some, but not all, of the stockpile
reserves during a State disaster emergency, provided that within 30 days of the
end of the State disaster emergency, the stockpile reserve is fully
restored.
(3) Mass casualty plan. The
plan shall explain how the hospital will receive and treat mass casualty victims,
in the event of a secondary disaster arising from the interruption of normal
services resulting from an epidemic, earthquake, flood, bomb threat, chemical
spills, strike, interruption of utility services, nuclear accidents and similar
occurrences, while addressing the continued need for surge capacity for the
underlying state disaster emergency declaration.
(4) Staffing plan. The plan shall explain how
the hospital will: identify and train backups for employees who may be unable to
report to work during a pandemic; institute employee overtime protocols; and
increase staffing by inter- and intra-system loan, cross-training, and volunteer
programs, which would be operational on seven days' notice.
(5) Capital plan. The plan shall explain how
the hospital shall ensure continuous operation of facilities and access to
utilities, materials, electronic devices, machinery and equipment, vehicles, and
communication systems. The plan shall ensure that the hospital routinely performs
all required maintenance and peak load testing of its infrastructure systems,
including: electrical, heating, ventilation and air conditioning (HVAC), and
oxygen supply.
(b) The
Chief Executive Officer (CEO) of the hospital, or system if authorized by the
Commissioner to report on a system-wide basis, shall certify to the review and
approval of the plan, including an attestation that it can be implemented and
achieved in the event of a declared disaster emergency. The CEO shall be
responsible for ensuring that the plan is reviewed and updated, as necessary,
periodically as specified by the Commissioner and shall re-certify that it is
able to be implemented and achieved upon each review.
(c) The Department may require the hospital to
submit its disaster emergency response plan and history of semi-annual
certifications for review, and may require the hospital to make such amendments
to the plan as the Commissioner deems appropriate, to ensure that the plan will
achieve the requirements established in subdivision (a) of this section,
including increases in bed capacity.
(d) In the event of a declared state disaster
emergency, any or all hospitals shall execute their plans immediately upon the
direction of the Commissioner.
(e)
Additional preparedness requirements.
(1) PPE.
Every hospital shall, at all times, continue to maintain the required 60-day
supply of PPE appropriate for use in a disaster emergency including a pandemic,
pursuant to section
405.11(g) of this
Title.
(2) Information technology.
Every hospital shall ensure that non-essential staff who are capable of working
remotely in the event of an emergency are equipped and trained to do so, and that
infrastructure is in place to allow for the repurposing of existing workspaces as
needed when activating the Surge and Flex System.
(f) Reporting requirements during the
activation of the Surge and Flex System.
(1) In
the event of a declared state disaster emergency, upon the Commissioner's
direction, hospitals or health systems shall report to the Department all data
requested by the Commissioner, in a manner determined by the Commissioner under
Section 306.2.
Such data may include, but shall not be limited to:
(i) Bed availability, both in total and by
designated service.
(ii) Bed capacity,
meaning acute care operational beds as defined in paragraph (a)(1) of this
Section.
(iii) Patient
demographics.
(iv) Other health
statistics, including deaths.
(v) PPE
and other supplies, in stock and ordered.
(vi) PPE and other supply usage
rates.
(2) Such reports
shall be submitted periodically as determined by the Commissioner, except and
unless otherwise directed by the Department.